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Individual

SHANNON AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
61 COOPER ST, AGAWAM, MA 01001-2149
(413) 786-8000
Mailing address
115 REVERE ST, SPRINGFIELD, MA 01108-1314
(413) 218-2664

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2909
MA
225X00000X
Occupational Therapist
Primary
11392
MA

Other

Enumeration date
04/07/2015
Last updated
04/07/2015
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